MedicaidPrior AuthMedium impact
Adzynma (ADAMTS13, recombinant-krhn) (Revised)
Humana·IN · Hematology·Medicaid
We identified it
Jul 21, 2026
Summary
This is a revised Prior Authorization policy for Adzynma (ADAMTS13, recombinant-krhn) affecting Medicaid Indiana members. The policy establishes new or updated authorization requirements for this rare disease medication. Billing teams must implement prior authorization protocols immediately to avoid claim denials.
Action Required
Immediately: Billing team must contact Humana Indiana Medicaid to obtain the complete policy details from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584860), as only a summary is currently available. Once full policy is retrieved, implement prior authorization requirements for Adzynma in the billing system. Update encounter forms and provider alerts to flag this drug for PA before submission. Train billing and clinical staff on authorization procedures. Do not submit Adzynma claims without prior authorization approval from Humana Indiana Medicaid, as claims will be denied without it.